Author Topic: Fee  (Read 4012 times)

margemib

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Fee
« on: August 18, 2009, 03:01:15 PM »
Hi Michele,
When you meet with a potential client, and they ask what you charge do you usually give them a figure at that time or go back to the office and figure it all out?
margemib
Margie Finlay CMRS

Michele

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Re: Fee
« Reply #1 on: August 19, 2009, 06:36:09 AM »
It depends on what type of provider they are and how much specific info they can give me in the meeting.  For example, if it is a social worker, solo, who sees 25 patients a week and it is mostly BCBS, they are in network, etc, I can usually give them a quote right there.  But if they are vague at all, or they aren't sure of their numbers then I need to gather some info before I can give a quote.  Also, I make it clear that it can be re-evaluated.  That way if they tell me they see 25 patients a week, and I find I'm billing for 40, I can make an adjustment.

Michele
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margemib

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Re: Fee
« Reply #2 on: August 19, 2009, 06:48:59 AM »
Thanks Michele!
Margie Finlay CMRS

dfranklin

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Re: Fee
« Reply #3 on: August 21, 2009, 10:37:37 AM »
Michele,
In your example how much would that be for the 25? 40? what would the billing look like in the agreement?  Meaning how is it laid out and how does it adjust for the additional?

Thanks!

Michele

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Re: Fee
« Reply #4 on: August 21, 2009, 11:07:53 AM »
Again, it would depend on the provider.  A mental health provider with higher charges and same patients week after week  wouldn't be the same as another provider who has new patients all the time, or who's charges are lower per visit.  I just make sure if the billing increases we are able to increase our fees.  We constantly evaluate our accounts to make sure we are in line with our fees.  It's tough to learn, but it gets easier.  % is definitely an easier way, but it is wrong - so we must use other methods.

Michele
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PMRNC

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Re: Fee
« Reply #5 on: August 21, 2009, 12:45:56 PM »
I'm not sure if % based is easier or just more convenient <g>
Here's what I know to be fact.. whenever you are determining a fee or even a %, the first figure you always start out with is how much you want to make, how much is your time WORTH? All the other variables are weighed in AFTER you have those numbers in your head.
The next thing you want to do is figure out how many hours a week you will need to spend on a particular client. The next thing you do is deduct expenses/costs. When all is said and done you should arrive BACK to the figure you sat down with (what you want to make) whether it's hourly, monthly etc.   If you are billing an hourly rate of course it's easy because the more time you put in, the more money you make, if you are billing a flat fee you will want to adjust the fee by volume.. maybe it takes you an extra hour per day for another 2-3 patients, maybe another hour for those extra patient statements, etc. etc. etc.

If I crunch the numbers.. I'm coming out better with a flat fee and sliding scale. Remember it all goes back to HOW MUCH YOU WANT TO MAKE AND HOW MUCH YOU ARE WORTH!
Linda Walker
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Pay_My_Claims

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Re: Fee
« Reply #6 on: August 21, 2009, 03:58:29 PM »
I agree with you Linda. When I first decided to simply go to a flat fee rate and negate all this % billing I immediately thought about the $$ I could lose.  :o I could be cheating myself. If I continue to focus on the possibility of losing a dollar, I will get nowhere. I work 8 hrs per day at XX.00 per hr.  If I have 4 providers and charge them XX.00 per hr x 8 but can do it in 2, I am making my current salary x 4. I am still working 8 hrs a day but making my salary x 4.........

crunch time.... medical biller salary could be 15.00 per hr. She/he makes 600 per week. 2400 per month. Charging each provider 2400 she/he would be making 9600 per month. Now lets say % wise she would want to charge an average of 8% In order to make this her physicians would have to have reimbursements of at minimal 120,000. That would mean each provider would have to bring in 30K a month minimal in order for them to equal the flat fee amount. This could be the case, or not be the case. Flat fee guarantees the money. Claims are filed constantly where the balance is applied to the clients deductible....no payment for % billing. Clients insurance has lapsed, no auth obtained anything......no payment for % billing. I'm going to flat-fee it..


PMRNC

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Re: Fee
« Reply #7 on: August 21, 2009, 05:24:33 PM »
Exactly!!  You get paid for the time you put in.. period! yes some will argue and think a percentage is an incentive, however that in turns makes the argument about why we will be moving away from all % based billing. I predict this will be coming down the pike soon. I've paid my dues, proven myself, my time is worth money :)
Linda Walker
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Pay_My_Claims

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Re: Fee
« Reply #8 on: August 21, 2009, 08:12:42 PM »
Amen!!

Michele

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Re: Fee
« Reply #9 on: August 23, 2009, 06:13:29 AM »
To me easier and more convenient have similar meaning, and that was the point I was making.  Even though it may be easier AND more convenient it is NOT the way to go.  I didn't anywhere in my post say or indicate that I don't charge what I deserve to be paid and what my time is worth.

Michele
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PMRNC

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Re: Fee
« Reply #10 on: August 23, 2009, 08:25:07 AM »
Hey Michele, I wasn't implying you didn't, I didn't mean to give you that impression! I was just speaking in general terms because so many of us became accustomed to %. I'm including myself in there too.
Linda Walker
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Pay_My_Claims

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Re: Fee
« Reply #11 on: August 23, 2009, 08:28:05 AM »
I didn't take it that way, but I must say that it is a matter of choice which way you decide to bill. There is no right or wrong in that. If I take a florida provider, can i bill by %? Do I want to have separate fee's for each provider I deal with. Each specialty has a difference. Some are high volume, but low charges. So in this case % billing would over-work you and get you less reimbursements than flat fee billing. Some are low claims, but high reimbursements, where % billing may bring you in more money. There are a lot of factors involved in deciding how to bill and how much. I decided to choose flat fee billing for a variety of reasons. It will give me a consistent expected monthly revenue. It eliminates the stress of worrying about client termination how much they owe me. It eliminates states with the fee splitting law, and for providers it will be a consistent payment. There are cases where you can replace 3 billers and % fee will still benefit the provider. What about specialty practices (cardiology, DME) where the claims are low, but reimbursement is high. Providers that only have 1 biller, but high reimbursements??  It is a whirlwind of decisions, and a choice that is eventually the decision of the owner.

Michele

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Re: Fee
« Reply #12 on: August 23, 2009, 07:37:08 PM »
I agree with all of that.  The other methods make my income more consistent.  I think that most people that enter the field for the first time come in thinking that % is how you bill.  The post I was responding to seemed to be someone new to the field.  People are mislead, by so many out there that are doing it wrong, and teaching it wrong.  It is an uphill battle.

Michele
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Pay_My_Claims

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Re: Fee
« Reply #13 on: August 23, 2009, 08:10:08 PM »
Michelle you have said a mouthful!!  I have learned so much just by joining forums, reading and researching. When I first decided to become self-employed I had visions of "sugar plum fairies" in my head. Bam!! reality hit me hard. OMG all the different specialties, the different scenarios. Linda and her fee splitting warnings..LOL This has to be what I want to do, because I am still here. As a "newbie" (i still feel like one) we owe ourselves to help ourselves. These forums are to help you, but sometimes we use it as a crutch. When I see you, Linda, or steve post a question in the group, it makes me feel good. It lets me know that the learning process never ends, and I'm headed in the right direction.

Michele

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Re: Fee
« Reply #14 on: August 24, 2009, 07:19:21 AM »
When you think you know it all it's time to retire!  JMO but there is always more to learn.  I'm thankful to the people sharing on this (and other) forums because I'm learning a lot.  And I love to see other peoples viewpoints and opinions.  I may not always agree  :) but I still love to see them, and sometimes (not too ofter) I may find out I was wrong!  LOL.

Michele
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